Evaluating an international web-based intervention to change GP prescribing: a triangulation of mixed methods data.

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The problem

Antibiotic resistance poses a great threat to society and effective interventions are needed to promote more prudent prescription of antibiotics in primary care. In a randomised controlled trial a multifactorial international intervention, GRACE/INTRO, showed to be effective at changing the prescribing behaviour of general practitioners (GPs). This study triangulated the qualitative and quantitative data which were collected as part of the process evaluation of the trial.

The approach

A mixed methods triangulation design. Qualitative data were collected via interviews with 62 patients and 66 GPs. Quantitative data were collected via questionnaires completed by 346 GPs and 2886 patients. Data from all sources were triangulated in order to explore convergence, complementarity and dissonance between the evidence. Three researchers agreed on the main findings from each data set and then worked independently to compare findings across data sets. Final triangulation was agreed by consensus.


Thirty-nine independent findings were identified across the four data sets. No instances of dissonance were identified. There were several instances of full agreement between data sets but more instances of partial agreement. Instances of partial agreement highlighted some examples where GPs and patients viewed the intervention differently. Qualitative and quantitative data complemented each other to provide a more holistic view of how the intervention was implemented.Consequence: The triangulation of data showed that the evidence from different sources was consistent. The combination of this data provided greater insight into explaining how the intervention worked to change clinician prescribing behaviour. The results highlight the benefits of mixed methods design to evaluate the implementation of interventions in general practice.


  • Sarah Tonkin-Crine, University of Antwerp, Antwerp, Belgium
  • Sibyl Anthierens, Cardiff University, Cardiff, UK
  • Kerry Hood, University of Southampton, Southampton, UK
  • Lucy Yardley
  • Paul Little